Article Figures & Data
Figures
- Fig 1.
High-resolution axial pre- (A) and post contrast (B) BBMRI demonstrates patent bilateral MCAs with normal intraluminal hypointensity (black-blood) due to flow-suppression techniques. Normal thin vessel wall or marginal periarterial enhancement (arrows) is observed on post-contrast versus pre-contrast imaging, best delineated in the inset (arrowheads).
- Fig 2.
A 39-year-old patient who presented with left-sided hemiplegia. MR DWI axial (A) shows restricted diffusion (arrow) in the periventricular white matter, consistent with an acute infarct. Axial pre-contrast (B) BBMRI demonstrates a focus of grade 2/strong intraluminal T1 hyperintensity (thick arrow) in the distal M1 segment proximal to the MCA bifurcation, compared with the normal retroglobal orbital fat (thin arrow), suspicious for an acute/subacute occlusion. DSA anteroposterior image (C) confirms the M1 right MCA occlusion (black arrowhead), after supply to a prominent anterior temporal branch.
- Fig 3.
A 63-year-old patient who presented with nausea, vomiting, and double vision secondary to multiple posterior circulation strokes. Axial pre-contrast BBMRI (A) shows a focus of grade 1/weak intraluminal T1 hyperintensity in the basilar artery (thick arrow), replacing the normal intra-arterial black-blood signal of the M1 segment (arrowhead), but less intense than in the orbital fat (thin arrow). Axial post-contrast BBMRI (B) shows grade 2/strong intraluminal contrast enhancement (thick arrow) of the basilar artery thrombus, compared with the normal avidly enhancing signal of the infundibular stalk (thin arrow). CTA (C and D) at the level of pons and the circle of Willis confirms occlusion of the basilar artery (white arrowhead) with distal basilar tip reconstitution (black arrowhead) from the anterior circulation via the posterior communicating artery.
Tables
Anterior (n = 22) Posterior (n = 16) P Value Mean age (range) (yr) 59.3 (34–77) 63.1 (39–79) .24 Male (%) 40.9 62.5 .32 Median time between BBMRI and CTA/DSA days (range) (day) 3 (0–18) 1 (0–20) .62 Occlusion chronicity (%) .02 Acute/subacute 59.1 18.8 Chronic/incidental 40.9 81.2 Hyperintensity (%) .29 Grade 1 77.3 56.2 Grade 2 22.7 43.7 Enhancement (%) .99 Grade 1 18.2 12.5 Grade 2 81.8 87.5 Acute/Subacute (n = 16) Chronic/Incidental (n = 22) P Value Mean age (range) (yr) 58.1 (34–77) 62.9 (37–79) .16 Male (%) 50% 50% .99 Median time between BBMRI and CTA/DSA (range) (day) 3 (0–18) 1 (0–20) .8 Occlusion site (%) .02a Anterior 81.2 40.9 Posterior 18.8 59.1 Hyperintensity (%) .04a Grade 1 87.5 54.5 Grade 2 12.5 45.5 Enhancement (%) .99 Grade 1 12.5 18.2 Grade 2 87.5 81.8 ↵a Significant.
